Trainers group makes mental health recommendations

INDIANAPOLIS (AP) — The National Athletic Trainers Association wants colleges to start treating the mental health of college athletes just as seriously as they do physical well-being.

The organization outlined a set of broad guidelines Wednesday that it believes should be adopted in an effort to help athletes cope with everything from depression to suicidal thoughts. The recommendations include using athletic trainers and team physicians to help with early detection of potential mental illnesses, provide advice and make treatment referrals while maintaining patient confidentiality.

Those who have dealt with mental illnesses say it's overdue.

"If you're an athletic director, and you want to be successful and you want to have good programs that are going to help your bottom line, wouldn't you want the healthiest student athletes you can have? Wouldn't you want the best mental health care providers and the best program in the country?" said former Michigan defensive tackle Will Heininger, who battled depression in college.

NATA believes there are more athletes like Heininger and that they are more likely to confide in trainers and team physicians than coaches or peers.

It's no coincidence that NATA used the NCAA headquarters in Indianapolis to announce its campaign.

Under President Mark Emmert, the NCAA has instituted a series of new concussion protocols that include requiring doctors to clear players before allowing them to return to the field and harsher penalties, up to and including suspensions, for players who make dangerous hits during games. Now the NCAA is part of the task force urging changes.

Now NATA is calling on university administrators to address mental illness with the same fervor.

"There's a stigma there, and they still don't want to seek help," said Dr. Margot Putukian, the head team physician at Princeton and one of the doctors who has worked with the NFL on establishing return-to-play policies following concussions. "So, you have a group of individuals that have inherent in them this issue of driving, pulling, pushing through any kind of obstacle. So when they have a mental health issue, oftentimes, they think there's that obstacle — that they don't want to seek help because they see it as a sign of weakness."

The paper, entitled "Developing a Plan to Recognize and Refer Student Athletes with Psychological Concerns at the College Level," cites studies that show the rate of mental illness is twice as high for adults 18 to 25 years old as it is those age 50 or older. Statistically speaking, NATA said, the probability of having college athletes on campus with some form of mental illness is a virtual certainty.

While the root causes of mental illness vary, NATA said athletes face potentially daunting mental hurdles when they suffer season-ending or career-ending injuries and again when they return from serious injuries. Depression, fear of another injury, attention-deficit hyperactivity disorder and even suicidal thoughts can crop up. But the most prevalent symptom among college athletes tends to be substance abuse.

"Despite the risk of negative results, including diminished performance and loss of scholarships, collegiate athletes seem to use most substances and alcohol at higher rates than do age-matched non-athletes in the college population," the report said. "Student-athletes were more likely to report binge drinking than the general student population because they viewed alcohol use as normal."

NATA believes athletic departments should do a better job tracking athletes by including questions about their mental health history during the physicals all athletes must pass to play. If trainers or doctors detect any potential concerns, they believe they should be able to approach those athletes and refer them to qualified university administrators and counselors.

NATA continues to maintain that patient confidentiality is essential, too. And it wants schools to review their insurance policies to determine when coverages would be triggered by a mental health incident.

But the most important part is simply helping athletes cope with mental illness.

"This is a real issue that affects real people," Heininger said. "Being susceptible to depression is part of the human condition. Knowing how to deal with it and being aware of your emotions is invaluable. If I had never come forward, I'm not sure what would have happened."

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